I have noticed the same, Some time back I had a lot of nursing homes on my books, now it is rare I get a call from one due to the fact it is all done in house by the cleaners. Nursing homes are not as rich as they used to me due to strict regulations placed upon them, so in many cases they have a budget to work to, so its cheaper for them to clean the carpets etc by themselves, however it will always be worth a try..
Duncan